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Cardiac hemodynamics and proinflammatory cytokines during biatrial and right atrial appendage pacing in patients with interatrial block. | LitMetric

AI Article Synopsis

  • Interatrial block (IAB) is linked to sinus node disease and contributes to various cardiac issues, and the study aimed to compare biatrial (BiA) pacing with right atrial appendage (RAA) pacing in patients with IAB.
  • In the study with 28 patients, BiA pacing improved cardiac output and decreased lung pressure, along with lowering levels of inflammatory markers and neuropeptides compared to RAA pacing.
  • The findings suggest that BiA pacing is more effective than RAA pacing in enhancing heart performance and reducing inflammation in patients with IAB.

Article Abstract

Purpose: Interatrial block (IAB) frequently coexists with sinus node disease and is considered a risk factor of left atrial dysfunction, atrial arrhythmias, and heart failure development. Conventional right atrial appendage (RAA) pacing impairs intra- and interatrial conductions and consequently prolongs P wave duration. Biatrial (BiA) pacing helps correct IAB, but its advantageous influence remains controversial. The aim of the study was to compare the effects of BiA and RAA pacing on cardiac hemodynamics and serum concentrations of inflammatory markers and neuropeptides.

Methods: Twenty-eight patients with IAB and preserved atrio-ventricular conduction treated with BiA pacing were studied. Standard invasive hemodynamic measurements were performed during BiA and RAA pacings. Furthermore, the influence of 1 week of BiA and RAA pacing on neuropeptides: atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) and markers of inflammation: high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and neopterin was examined.

Results: BiA pacing resulted in significant increase of cardiac output (CO) and reduction of pulmonary capillary wedge pressure. We demonstrated significantly lower concentrations of ANP, hs-CRP, IL-6, and neopterin after 1 week of BiA in comparison to RAA pacing. BNP levels remained unchanged.

Conclusions: BiA pacing in comparison to RAA pacing improves hemodynamic performance in patients with IAB and preserved atrio-ventricular conduction. BiA pacing is associated with reduction of ANP and markers of inflammation (hs-CRP, IL-6, and neopterin).

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698432PMC
http://dx.doi.org/10.1007/s10840-013-9792-8DOI Listing

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